As trends in health care move more toward outpatient care and away from hospital-based care, home health care will continue to expand. Helping patients transition home from hospitals has long been a focus of home health. Now the focus is on keeping patients at home and preventing or diminishing hospitalizations.

Duties, Activities, and Scope of Practice

As with all health care administrators, home health care administrators have to stay on top of changes in reimbursement, regulations, billing, and other conditions of participation with federal agencies such as Medicare and Medicaid. Home health care has been subjected to multiple changes in recent years.

Home health care administrators also deal with patient services, strategic planning, personnel, finances, materials management, operations, and relationships with the medical community (practitioners, hospitals, skilled-nursing facilities, community agencies, etc.), and must have a clear understanding of the home health care delivery process.

They usually have a team of assistants handling each of these areas, but in small agencies all these responsibilities may fall on the administrator.

Education and Training

The industry standard is a master's degree in health care administration or an M.B.A. Administrators need to have a clear understanding of health care economics, certification processes from Medicare and state health departments, other legal and regulatory issues, information management, quality and risk management, public relations and marketing, biostatistics, and epidemiology.

Licensure/Certification

Currently there is no required license or certification. The National Association for Home Care and Hospice (NAHC) is promoting a program for certification of home care and hospice administrators to set standards for professionals. There have been many issues of fraud and abuse in Medicare-certified home care agencies in the past twenty-plus years that have brought about many changes in regulations and procedures. Certification of administrators could help to contain these issues and protect the consumer. For further information about the certification program, visit NAHC's Web site, at http://nahc.org/CHCE/about.html.

Work Settings and Salaries

Home health care administrators work long hours and must be on call for emergency issues. Almost all home health care is provided on a continuous basis through after-hours, on-call systems. Home health agencies can be for-profit or nonprofit. They can be freestanding or part of a hospital system.

Career Potential and Additional Information

Home health care is expected to grow much faster than the average for all occupations over the next decade. Medicare has periodically placed moratoriums on certification of new agencies in the past; however, the number of home health agencies is continuing to expand to meet the needs of an aging population and of the health care industry, which is moving toward a focus on outpatient settings for care.

For more information on a career as a home health care administrator, contact the American College of Healthcare Executives. Their Web site is www.healthmanagementcareers.org. Their address is One Franklin Street, Suite 1700, Chicago, IL 60606-4425.

Or contact the National Association for Home Care and Hospice (NAHC). Their Web site is www.nahc.org. Their address is 228 Seventh Street, SE, Washington, DC 20003.